The Asian Conference on Psychology and the Behavioral Sciences 2014 Official Conference Proceedings Osaka, Japan The Relationship between Islamic Religiosity, Depression and Anxiety among Muslim Cancer Patients Nadzirah Ahmad Basri, Kyushu University, Japan Gan Chun Ho ng, The National University of Malaysia, Malaysia Ng Lai Oon, Sunway University, Malaysia The Asian Conference on Psychology & the Behavioral Sciences 2014 Official Conference Proceedings 2014 0439 Abstract There is a growing body of evidence that religiosity and spirituality can buffer depression and anxiety and support the healing process in cancer patients. However, literature on the role of Isl amic religiosity in the healing of Muslim cancer patients are few. This study aimed to examine the relationship between Islamic religiosity with depression and anxiety in Muslim cancer patients. 59 cancer patients were approached in oncology day care and w ard at a Malaysian government hospital and in a cancer support group activity. Patients completed the Muslim Religiosity and Personality Inventory which assessed their Islamic religiosity scores through the constructs of Islamic beliefs and Manifestation o f Islamic belief. Self -rated depression and anxiety were assessed using validated Beck Depression Inventory and Beck Anxiety Inventory in Malay. Ten of the patients were interviewed about their spiritual experiences and emotions. Questionnaire findings rev ealed a significant negative correlation between Islamic religiosity with depression and anxiety. Higher manifestation of Islamic belief was associated with lower depress ion while higher Islamic belief was associated with higher education. Higher Islamic r eligiosity was associated with older age, married and pensioned patients. Interview findings revealed that being ill brought the patients closer to God and many thanked God for the blessing and time spared for them to repent and do more good actions. All of them used prayers to heal their pain. Patients also reported strong feelings of anger, frustration and sadness after the initial diagnosis which slowly disappeared as they began to accept their illness as a blessing in disguise. It is concluded that the re is a need to respond to the meaning and values given to human existence besides responding to physical and mental suffering in cancer patients. iafor The International Academic Forum www.iafor.org 677 The Asian Conference on Psychology and the Behavioral Sciences 2014 Official Conference Proceedings Osaka, Japan INTRODUCTION Depression and anxiety are among the most commonly reported psychological symptoms among can cer patients. Studies have found depression and anxiety to be high after patients receive hospital treatment (Lue, Huang and Chen, 2008) and when they are in pain (Petkova, Nikolov, Galabova and Petrova, 2010). In spite of the psychological symptoms commo nly associated with cancer, studies have also shown that cancer and other life -threatening diseases have been found to raise acute existential concerns in many of the patients (Cunningham , 2005). It has also been found to deepen faith which transcends reli gious and ethnic differences and the internalization of a spiritual response to a life -threatening illness as well as the expression of spirituality may feel more similar to each other than different (Levine et al. , 2007). Studies have also related on the associations between spirituality and religion with psychological symptoms among cancer patients. One such research indicated that religion and spirituality have been found to predict a decline in depressive symptoms, an increase in vitality, improving me ntal health and lowering cancer -related distress (Yanez, Edmondson, Stanton, Park, Kwan, Ganz & Blank , 2009). However, a search in the literature saw that many of the studies which explored on the relationship between religiosity and spirituality with m ental health found that spirituality played a more significant role than religiosity in relation with lowered tendency of depression and anxiety (Mystakidou, Tsilika, Parpa, Smyrnioti & Vlahos, 2007) and an increase in quality of life ( Rippentrop, Altmaier and Burns, 2006). In the present literature, a high proportion of spirituality -mental health connections studies have been conducted mostly within populations of US Christians of one denomination or another and thus the work is not global. It is also sai d to have no therapeutic impact of spirituality on mental health, rather it has more of protective effects rather than therapeutic (Levin , 2010). Currently, there are very few studies on the relationship between Islamic religiosity (the religion of the Mus lims) with the Muslims` psychological health particularly among cancer patients. One such research is a qualitative study among three Malaysian Muslim women with advanced breast cancer, whereby the women initially had feelings of self -doubt regarding thei r relationship with Allah (the Muslims` name for God) but later on the confrontation prompted a turn to spirituality and reminded them to open themselves more deeply to Allah. They view life as a trial in preparation for life in the Hereafter, and hence th is becomes their greatest motivator to continue striving and being committed to continuous self -development. (Ahmad, Muhammad and Abdullah, 2010) Another research on Muslims is among Iranian cancer patients undergoing chemotherapy whereby they were found to have a heightened attitude towards prayers. They gained higher scores in the subscale of attitude towards prayers in which among the items were “My prayers have helped me adjust to the diagnosis of cancer” and “I know God is taking care of me now” (Reza ei, Adib -Hajbaghery, Seyedfatemi & Hoseini , 2008). 678 The Asian Conference on Psychology and the Behavioral Sciences 2014 Official Conference Proceedings Osaka, Japan These two studies indicated that the Muslim cancer patients had increased their connections with God (Allah) with the knowledge of their contraction with cancer. DIFFERENCES IN DEFINITIONS OF RELIGIOS ITY AND SPIRITUALITY In the Western psychology literature, the term religiosity connotes a different meaning than spirituality which is in contrast with Islam, which does not differentiate between religiosity and spirituality, In the Western literature, religiosity is almost always defined as a shared system of organized beliefs and practices which involves a Higher Power, (Mystakidou et al. , 2007), and the desire to please that power (Mc Coubrie and Davies , 2006). It also defines the nature of God and gu ides worship (Meraviglia et al. , 1999). On the other hand, spirituality is defined as people’s understanding of their lives in terms of their ultimate meaning and value (Mystakidou et al. , 2007). It is an aspect of the self which searches for meaning, at tempt to make sense out of life events, and which seeks to reconcile one's experiences with personal beliefs (Boeving , 2000). It may exist without religious beliefs or practices and may also co - exist together (Mc Coubrie & Davies , 2006). From the Islami c perspective, religion is the broader construct which encompasses a ‘way of life’. Religion provides the roadmap to one’s ultimate purpose in life, that is, to live continuously in relationship with God, the Creator. Thus, the separation between religion (the roadmap) and spirituality (the purpose the roadmap serves), most likely, is not accepted in the Islamic way of life. This is because to be spiritual but not religious may make a person spiritual but without religion or a road map to reach God; he or she may be misguided. Similarly, to be religious but not spiritual may make a person religious, but without self - understanding and consciousness, he or she is considered spiritually dead. Therefore in Islam, religion and spirituality are integrated into a unitary way of life (Ahmad et al. , 2010). PURPOSES OF THE STUDY 1. To examine the relationship between religiosity and depression among Muslim cancer patients. 2. To examine the relationship between religiosity and anxiety among Muslim cancer patients. 3. To explore the spiritual experiences of Muslims with cancer. 679 The Asian Conference on Psychology and the Behavioral Sciences 2014 Official Conference Proceedings Osaka, Japan METHODOLOGY Participants Participants were recruited while they were attending oncology daycare and ward in a Malaysian public hospital and a cancer support group. The inclusion criteria were Mus lims with diagnosis of cancer. 59 patients participated in the survey and 10 of them participated in the interview. Participants range between 15 -65 years old. The study was conducted between July to August 2010. Procedures Once ethical approvals were obt ained, the researcher approached cancer patients at oncology daycare and ward and explained about the research. Patients who were not able to fill in the questionnaires due to physical incapability or sight problems were assisted by the researcher by readi ng out the questions to them. Once patients had given their written consent, basic demographic details were collected. Patients were then asked to complete three sets of questionnaires: i) the Beck Depression Inventory (Malay) ii) the Beck Anxiety Inventor y (Malay) and iii) The Muslim Religiosity and Personality Inventory (Malay) short version. Participants were also recruited while they were attending activities at a cancer support group. They were given an explanation about the research and the questionn aires in a self -addressed envelope were given to them